1168: Strengthening Pennsylvania's Emergency Response System

JOHN SHEEHAN: 

This is Public Health Review Morning Edition for Monday, July 20, 2026. I'm John Sheehan with news from the Association of State and Territorial Health Officials.

 

Reliable emergency medical services require sustained investments in equipment, workforce development, and preparedness. Today, ASTHO member and Pennsylvania Secretary of Health Dr. Debra Bogen returns to tell us how the state's latest $6.6 million investment in EMS is improving patient care, supporting first responders, and strengthening emergency response across Pennsylvania.

 

DEBRA BOGEN: 

This $6.6 million investment in Governor Shapiro's proposed budget comes from our EMSOF funds, the Emergency Medical Services Operating Fund, we all call it EMSOF here in Pennsylvania, and this fund helps EMS agencies acquire state-of-the-art equipment, training, and recruitment and retention. Over the last couple of years, the Shapiro administration has invested about 56 million in Pennsylvania's EMS industry. This particular $6.6 million is specifically around those three areas. So, in Pennsylvania, we have 13 EMS regional councils that are spread across the state, and within those, they oversee the agencies in their region. We have a little over 1,000 agencies in Pennsylvania across the state, and we are trying to level kind of the playing field and make sure that people have really access to this fund of money across the state. So, the money goes to the regional councils to be distributed through the agencies. A number of the regional councils have purchased video laryngoscopes to improve intubation, and that is when you know a tube is passed into the airway to help people breathe. More than one and a half million people every year in the United States have this procedure performed outside of hospitals by EMS, and so when you use a video laryngoscope, you're able to observe the airway with a video camera. So, your success at passing the intubation tube successfully at the first time greatly increases, and that increases more speedy oxygenation for the patient and better outcomes. And so, each region can pick a different choice of equipment, but within a region, they're all the same, so that they can do shared education and learning from the equipment that they purchased, and then they can also observe outcomes. And so, we're very excited about this, and they're equitably distributing them. Meaning, if an agency doesn't currently have any, they make sure that those agencies get first purchase, and then if an agency has out-of-date ones but they still have them, they will get them later. That's one example of equipment that they have purchased. They've also purchased lift assist devices. We know the number one cause of injury to EMS workers is back injuries and lift injuries, and so the lift equipment reduces injuries, so it keeps our EMS workforce healthy and in the field, and not out on sick leave, so that's an important piece of equipment. And they purchased other ones. Again, each region decides what equipment is most needed in their region, so, very excited. And then the other money, of course, is used for training and for recruitment and retention as well.

 

SHEEHAN: 

Yeah. And what kind of metrics are you looking at to sort of gauge the impact of those investments?

 

BOGEN: 

So, for the video laryngoscopes, you can look at success first pass success rates, and we really like to see that we get an increase from the mid-70s at first pass success to into the 90th-percentile. So, we're tracking that. The cameras in the video laryngoscopes are also really important for teaching because there's a video associated with the intubation. You can go back and learn from your experience. And so, it's a continuous learning loop for things like lift assist devices. The reduction in injuries to workers is another metric. So, it depends on what equipment they purchased, what metric they'll follow, but each one they can really look at the outcomes that are most associated with the purchase of that equipment.

 

SHEEHAN: 

And you mentioned another sort of bucket of the investments going towards workforce retention and recruitment. These are all sorts of national challenges. How is Pennsylvania attacking that issue with regards to EMS?

 

BOGEN: 

Yeah, thank you. EMS is definitely facing a number of challenges, as you said, and the reasons for that are varied, including their pay scale, but also the fact that you need to get additional training to advance in your career, and that's costly. So, one of the things that Pennsylvania has done using money actually from a fireworks tax that we have in Pennsylvania is that we've been able to reimburse people for tuition. So, if you're going to go from an EMT, an emergency medical technician, to an advanced EMT, that costs money, and so people can request reimbursement for their cost of their tuition. Similarly, if you're going to become a paramedic, that's a much more in-depth and extensive training, and that is quite costly. And you can ask for reimbursement. And so, we have tiers of how much you can get reimbursed for your training, and people have been using it. We've been reimbursing a lot of people across the state for that, and we hope we'll see with time that that has led to both people advancing in their careers as well as retention. We also know that it's really important to get people early in their careers, in their life, and let people know that this is an opportunity and option. So, we have been holding summer camps for interested students over the summers in high schools to promote EMS as a career, and that has been well received, and we continue to work on programs that really build the pipeline.

 

SHEEHAN: 

Does the Pennsylvania Department of Health integrate metrics from EMS such as response times or success rates? Does the department integrate that into its overall public health surveillance?

 

BOGEN: 

Yeah, so we, all of our EMS agencies across the state report their data about their encounters with patients into a system, and that data is then shared with the Department of Health, so we can use the statistics to look at how things are going and how we compare across the state, so we look at things like response time, procedure success rates, and we compare it to national EMS standards, and then we can identify areas of need. So, to try to troubleshoot if there's a particular area, does that do we need more education and that specific topics? So, we are really trying to use that data and make sure that we are using our data to inform our practices in the state.

 

SHEEHAN: 

So, these investments in EMS are definitely a step forward. Can you talk about the importance of making sure that EMS is properly funded and maybe the dangers of not funding emergency response services?

 

BOGEN: 

Absolutely, you know, every day, if there's an emergency, people will dial 911 and they expect an ambulance to show up at their door or wherever they're needed. They expect people to come in a timely manner, and they expect them to be well trained and prepared to respond, and it is, truly, EMS is a linchpin in our healthcare system that people really, I think, don't recognize until there's an emergency. So, when we underfund it, we will not be able to have that kind of response system, and we are, you know, we teeter on the edge of that right now because we really have struggles with how we fund EMS. We don't fund for readiness. The way EMS is reimbursed currently is you get called to a car accident and you transport somebody to a hospital. The ambulance is reimbursed for that. But if they're called to a house fire and they wait at a house fire for an hour or two or three, and they don't transport anyone, they're not reimbursed for that. So, what we have to do is find a way to consistently, because EMS is both a preparedness group as well as a response group, and so we need to find ways that reimburse them for readiness, just like we do fire and police, but we don't necessarily fund EMS in that same way, and so in order for EMS to be available for readiness and for responding to an emergency and transporting someone, we need to really think about that. I'll give you another example. As you know, we've had hospital closures, as have other states, and that means that EMS is having to transport people for longer distances, and when you take an ambulance from one community and drive it far away to another community, you're taking that ambulance out of service for that small rural community for a longer period of time, and leaving holes in the system. And so, we really need to think about EMS as part of the healthcare ecosystem, and how do we ensure that they are thoughtfully integrated in all aspects of that ecosystem. It is, they're all interconnected, and EMS truly I call it a linchpin because it really is the part of the healthcare system that moves people from place to place but provides incredibly expert care out in the community. Right, they're intubating people on the sides of roads in people's homes, they're providing blood en route. They are providing complex medications, conducting EKGs, etc. And so, we all need to make sure, all of us, that EMS is well funded, so they can continue to do that job.

 

SHEEHAN: 

Dr. Debra Bogen, thanks so much.

 

BOGEN: 

Thank you so much for having me.

 

SHEEHAN: 

Dr. Debra Bogen is an ASTHO member and Pennsylvania's secretary of health.

 

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On July 14th, the Centers for Disease Control and Prevention issued a Health Alert Network Health Advisory on Cyclosporiasis, current U.S. surveillance data, and recommendations for clinicians, laboratians, and public health departments to support recognition, diagnosis, and reporting. Learn more by accessing the Health Alert Network through the link in the show notes.

 

This has been Public Health Review Morning Edition. I'm John Sheehan for the Association of State and Territorial Health Officials.